#mulliganpt

#1 - You don’t have to live with the pain

If you’ve had physical therapy in the past and your injury or condition has started to bother you again, don’t get discouraged, but DO seize the day. Here’s a helpful perspective from my colleague Jerod Carter:

If symptoms return after treatment has concluded, it doesn’t mean that you have had a big setback. Moreover, it doesn’t mean that PT wasn’t the full answer to the problem. If you achieved pain-free status in PT before, it can be done again!

Please give my office a call if your injury has started to hurt again. I can get you back to doing the things you love.

#2 - Put exercise to work for you

I know our lives and the times we live in aren’t getting any less stressful, and this time of year can be especially difficult. But physical activity DOES help and is far from being just one more “to-do.” According to the Mayo Clinic, getting moving has immediate physiological benefits:

It bumps up your endorphins (your brain produces more feel-good neurotransmitters).

It lets your body systems safely practice working together through the effects of stress, providing protection for your cardiovascular, digestive, and immune systems.

It reduces anxiety and mimics the benefits of meditation. Focusing on your body’s movements can generate energy and help you feel more calm, clear, and focused.

Perhaps you know you need to exercise but have trouble making that happen either due to physical limitations or a lack of motivation. A physical therapist can provide excellent support in both of those areas. If you’re just starting out, I can address any pain you’re experiencing and design a gentle yet effective workout. If you already exercise, a consultation with me can change up your routine and provide accountability. I specialize in helping clients set and attain goals and I’d love to help you create a plan to manage stress and enhance your day to day life.

#3 - Get guidance on getting healthy

If you have a health-related “reset” in mind for after the holidays, you’re probably considering the many diet and exercise options out there – and there are too many to count! Why not make it more simple for yourself and talk it over with an expert? My practice has the tools you need to lose weight and improve your nutrition. 

For years, I’ve partnered with IDLife to offer my clients realistic, effective solutions that work because, like personalized PT treatment plans for my patients, this wellness approach is not cookie-cutter. IDLife is about as customized as you can get. A thorough assessment for every client ensures the regimen is completely suited to your needs and lifestyle, and we even offer DNA testing to analyze your body’s unique makeup and zero in on the fitness and weight loss strategies that will be most successful for you. No need to wait until the new year – come in today to understand your options and be ready to hit the ground running in January!

I’m thrilled to be embarking on this next chapter in a new facility, and I commit to maintaining the 100% personal, flexible, targeted, and efficient care that my valued patients expect and deserve. I truly look forward to seeing you soon!

Address: 3000 Cabot Blvd West, Suite 200, Langhorne PA 19047 

Hours: Monday through Friday, 8:30am to 5:00pm

Phone: (215) 968-0156

Be well,

The “why” behind hydration

About 60% of your body is made up of water. You continually lose water by breathing, talking, and perspiring; to keep your body in working condition you must replenish lost fluids. Drinking adequate fluids prompts better physical performance, energy levels, and organ function. It can also treat and prevent headaches, constipation, and kidney stones, and aid weight loss.

Besides being an important part of the fluids in your body (like blood, digestive juices, and the lymph fluid of the immune system), water is needed by each cell to work, including those in your brain. Most of us don’t realize that our brains are strongly influenced by hydration -- it impacts your mood, concentration, working memory, anxiety, and motivation.

A variety of ways to hydrate

Getting more water into your day can be as simple as making a few changes. Here are some of my favorites:

Power up your water. Almost any fluid will add value to our bodies, but water is the best choice, plus it has zero calories, can help suppress your appetite, and aids in digestion. To supercharge your water and add low-cal flavor, I love the taste and convenience of Hydrate packets from IDLife, a clean electrolyte replenisher that provides antioxidants and essential nutrients without added sugar. I just pour a packet into my water bottle, shake it, and go. (Read on for more about electrolytes and their important role.)

Snack on fruits and veggies. Cucumbers, leafy greens, radishes, celery, zucchini and tomatoes are vegetables with high-water content. Water-rich fruits include watermelon, strawberries, cantaloupe, peaches and pineapples. 

Have some oatmeal. Believe it or not, oatmeal is very hydrating - oats expand and absorb the water or milk they’re cooked or soaked in. Enjoy your oatmeal warm, or try overnight oats with this recipe from Feel Good Foodie, which includes an added boost with chia seeds that soak up 10 times their weight in extra liquid and keep you full.

Try various herbal teas, served hot or iced. Herbal teas like peppermint, lemon, chamomile, and ginger are a great source of hydration and contain no caffeine or calories (unless sugar or sweetener are added).

Find a healthier swap for dry, heavy carbs. Instead of bread, wrap your lunchmeat in lettuce, which is about 95% water. Or opt for zucchini noodles instead of spaghetti with your favorite tomato sauce.

Freeze your fruit. Homemade popsicles are a delicious way to rehydrate. Blend a hydrating ingredient like watermelon, fill your popsicle molds, and freeze for at least an hour.

How much is enough?

A common rule of thumb is to drink 64 ounces (8 cups) of water daily. There’s no scientific rationale to this adage, but it’s an appropriate starting point. According to the Mayo Clinic, adequate daily fluid intake is:

About 15.5 cups (124 ounces) of fluids a day for men

About 11.5 cups (92 ounces) of fluids a day for women

(These recommendations cover fluids from water, other beverages, and food. About 20% of daily fluid consumption usually comes from food and the rest from drinks.)

There’s no one formula -- the amount of water each individual requires will vary based on climate and altitude, general health, medications, and alcohol consumption. And, other factors like age and exercise can even affect the degree to which you experience thirst.

What about electrolytes?

If water is the gasoline that fuels your body, then electrolytes (minerals like sodium, chloride, potassium, magnesium, and calcium that maintain your body’s ionic balance) are the motor oil that keeps everything running. When you’re working out for longer than an hour or sweating a lot on a hot day, you might need to replenish your body’s electrolytes in addition to staying hydrated. 

Sports drinks (like Gatorade and Powerade) are well-known electrolyte boosters, but use caution: a 20-ounce sports drink can contain as much sugar as a regular-size Snickers bar or two servings of ice cream! Even low-sugar/low-cal sport drink varieties aren’t without drawbacks; most substitute acesulfame and sucralose for sugar and may contain food dyes, such as Red No. 40, Blue No. 1, and Yellow No. 5. These artificial dyes are derived from petroleum and may increase the risk of hyperactivity in children. They’ve also been linked to cancer.

To replenish electrolytes without added sugar or artificial ingredients, check out natural alternatives (another reason I love IDLife Hydrate) or consider making a healthier sports drink at home with this recipe.

A few final tips

Keep in mind that the body hides mild dehydration very well, so it can take hours before you realize that you’re dehydrated. That’s why an important strategy is to prevent dehydration by hydrating frequently. 

As with any new habit, consider starting with a smaller target for a week or two to establish the routine, then increase your goal from there. For more about forming healthy habits, visit my blog.

The bottom line? Even mild dehydration can affect you mentally and physically. Make sure that you get enough water each day, whether your personal goal is 64 ounces or a different amount. It’s an essential building block for your overall health.

Be well,

Brian

Track 1: “I Can’t Fight This Feeling Anymore”

There’s a huge emotional component to injury, disease, and recovery. Perhaps a friend dealing with shoulder surgery isn’t just unable to use her arm as accustomed, she’s sad that she can’t lift her toddler. An aging parent with a leg fracture may be eager to walk again but struggling with fear of putting weight on the leg and learning to trust it again. Or your spouse who struggles  with chronic pain may be experiencing depression and anxiety because he wakes up feeling unwell many days and isn’t certain what he’ll manage to accomplish. 

Gently encourage your loved one to share the emotions that accompany their situation. Getting these feelings out into the open can help to relieve stress and fear and prompt a better mindset toward physical therapy. Often, a counselor or mental health therapist can be instrumental in helping patients handle difficult emotions and refocus on improving their lifestyle and function.

Track 2: “Love Hurts”

It’s hard to see someone we care about experiencing discomfort and PT can definitely be uncomfortable at times.  I think WebMD puts it very well:

[Physical therapy] will be safe. But because you'll use parts of your body that are injured or have chronic pain, physical therapy can be challenging, even hard. For example, you may feel sore after stretching or deep tissue massage.

But there’s a reason for that. Your therapist has a specific plan in mind based on your particular needs. Sometimes to get stronger, you have to do some tough training. It will push you, but it shouldn't be too much.

Each person may respond differently to therapy. Your body type, daily activities, alignment, and habits all affect your plan. Stick with it, and you'll get the benefits.

Sharing specific details when asked, “how did you feel after our last session?” can allow the physical therapist to make adjustments, incorporate more stretching or strengthening techniques, and employ heat, ice, and electrical methods to help decrease pain or swelling after a therapy session. Help your loved one bear in mind, though, that the therapist’s job isn’t to pamper them, it’s to help them overcome pain and challenges, which can mean doing the very things they may not feel like doing to attain progress. 

The patient can and should be candid, too, if tempted to skip sessions or discontinue therapy. Ask them to talk to their therapist about their reasons for missing  treatment or quitting so that these reasons can be addressed. I’m always willing to help patients modify their approach rather than stop altogether.

Track 3: “Wind Beneath My Wings”

PT is hard work and it takes discipline to see it through. Here are some simple ways to lend ongoing, practical support: 

>> Cast a vision. Find out a specific goal that the patient is working towards and frequently help him or her envision the good things that will come from achieving that milestone; for instance, “there’s a festival we should check out once you’re more comfortable walking on the grass,” or “your grandson will love it when you can sit on the floor to play with his train set.”

>> Encourage progress at home. The biggest area that I see family members making a difference is with the home exercise program (HEP), an individualized set of therapeutic exercises that’s really one of the most important aspects of physical therapy. Research shows patients who comply with an HEP are significantly more successful at achieving rehab goals and tend to experience relief from pain more quickly. For more tips on home exercises, check out my article.

>> Educate yourself. Check out sites like www.choosept.com for easy-to-understand info about PT’s effectiveness in addressing various injuries and conditions.

>> Defer to the professional. You mean well and only have your loved one’s best interests at heart, but resist the impulse to interrupt a session or naysay the therapist’s advice. PTs are licensed rehabilitation experts with years of schooling and tons of experience. If you have lingering concerns and the patient is a family member, give the practice a call and ask for some time to speak with the therapist. 

Track 4: “Nothing Compares 2 U”

Anyone can encounter a tendency to compare their progress to others, whether that means other clients at the therapy clinic or accounts heard from friends or relatives. But I’m not being trite when I say that physical therapy is unique for each and every individual. Besides a myriad of different conditions, impairments, and degrees of severity, I’ve seen firsthand that personality, lifestyle, and circumstances heavily influence a patient’s progress and outcome - as does the quality of their support system. I don’t use cookie-cutter treatment plans, and my clients don’t experience cookie-cutter outcomes. Each person is on his or her own journey with PT. With the right treatment, they’ll attain the goals most appropriate for their life in the timing that expertly blends safety and effectiveness. If you or your loved one is frustrated by the pace, instead of making comparisons and getting discouraged, revisit my earlier tip and request a time to speak with the physical therapist. 

You have an important role in your friend or family member’s success in PT. Whether you team up to do home exercises, ask about their progress, help them get to and from appointments, or encourage perseverance when the going gets tough, you can help the one you love stick with PT, gain confidence, and achieve their goals.

Happy Valentine’s Day!

Be well, Brian

Step 1 - Assess risk

During a balance and gait assessment at my practice, I discuss the patient’s history (past falls, especially in the last year, and any recent hospitalizations or other causes of weakness or lost muscle mass) and any diagnoses like osteoporosis or arthritis. I assess their strength and stride and conduct a range of tests to check their balance. 

I typically ask about the patient’s medications, too. If you take multiple medicines (prescribed or over the counter), your risk for falling is higher. Many drugs can cause you to be dizzy, lose your balance or have blurry vision. Once identified, these side effects and medications can be discussed with your doctor or pharmacist. Additionally, it helps to be aware that fall risk increases significantly in the days following a medication change (start, stop, or dose change), according to some studies.

Step 2 - Implement a personalized treatment plan

The best treatment plans combine exercises to address four key areas: strength, balance, coordination and posture. Flexibility matters too, since range of motion in the legs or spine impacts your walking and gait pattern. I utilize various tools to get baseline scores and track improvement throughout the treatment plan and sessions.

In many cases, the best way to improve balance is to challenge it. We accomplish this by combining upper body and lower body movements, working on steps and curbs, practicing standing on one leg, and navigating unsteady surfaces. All of these potentially risky actions can be practiced safely and beneficially with the help of a trained therapist.

I can also help a client prepare for how to minimize injury if a fall can’t be avoided. We practice getting up from the floor, and we evaluate safety measures like life alerts or smartphone/smartwatch apps for fall detection. 

Importantly, my patients’ treatment course extends outside the clinic to touch their daily lives. We talk about the importance of staying active to maintain strength, flexibility, coordination and balance. Staying active has the added benefit of typically reducing your fear of falling. I help my patients select activities that they can do safely - yoga, swimming, walking, or other pursuits they enjoy.

Overall, physical therapy can be extremely effective in preventing falls and building confidence, and that leads to other benefits. Recently I worked with a client who was reluctant to walk on the grass for fear of falling, and as a result he’d missed out on many backyard picnics and his grandkids’ sporting events. When I help a patient like that achieve new goals and do things they thought they couldn’t, it improves so much more than their physical function, it improves their quality of life. It’s a privilege for me to play a role in that. 

If you or a loved one needs a falls screening and guidance about reducing risk, please contact me today.

Be well,

Brian